CMS Formulary

Displaying 125591-125600 of 1611142 results.
ID: 125591
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125592
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125593
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125594
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125595
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125596
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125597
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125598
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125599
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658221
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125600
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0